CPOE Implementation in ICU's

描述：(由申请人提供)：医疗保健技术可用于减少整个用药过程中的用药差错。然而，技术的实施也并非总是一帆风顺。这项应用建立在现有的跨学科研究网络之上，并建议在威斯康星大学医院和诊所(UWHC)的一家学术医院的6个重症监护病房中，在不同领域(患者安全、护理质量和最终用户)和不同级别(单位、患者和最终用户)检查CPOE技术的价值。该应用程序还旨在使用预期的人为因素分析方法来改进CPOE的设计和实施，并检查CPOE对最终用户的影响。在ICU实施CPOE的人因工程方法是独一无二的，由于其理论基础，可以为改进医疗机构CPOE的设计和使用提供重要的概念和方法方面的信息。本研究将在UWHC的6个ICU，即(1)创伤生命支持中心、(2)神经外科ICU、(3)心胸外科ICU、(4)心脏ICU、(5)烧伤病房和(6)儿科ICU，采用岗位前设计来检验CPOE实施的影响。我们建议评估以下领域的价值和结果：(1)患者安全-用药差错(ADE评估)，(2)护理质量(住院时间、死亡率、并发症和预防措施的使用)，(3)最终用户的工作任务和看法和态度(问卷调查和工作任务观察)，以及(4)财务影响(来自医院会计系统的数据)。所获得的信息将从两个方面促进患者安全方面的科学知识：(1)将更好地了解用药差错以及CPOE技术对ICU中这些差错的数量和严重程度的影响；(2)将分享在医疗保健中实施技术的人为因素方法以及对最终用户的影响，这项新技术可能在未来几年被广泛采用，即CPOE技术。

DESCRIPTION: (PROVIDED BY APPLICANT): Healthcare technologies can be used to decrease medication errors throughout the medication process. However, the implementation of technology has not always been without troubles. This application builds on an existing interdisciplinary research network, and proposes to examine the value of CPOE technology in various domains (patient safety, quality of care, and end users) and at various levels (unit, patient, end user) in 6 intensive care units of an academic hospital, the University of Wisconsin Hospital and Clinics (UWHC). The application also aims at using prospective human factors analysis methods for improving the design and implementation of CPOE, and at examining the impact of CPOE on end users. The human factors engineering approach to CPOE implementation in ICUs is unique, and, because of its theoretical basis, can provide important information on concepts and methods for improving the design and usage of CPOE in healthcare institutions. A pre-post design will be used to examine the impact of CPOE implementation in 6 ICUs at the UWHC: (1) Trauma Life Support Center, (2) neuro-surgery ICU, (3) cardio-thoracic surgery ICU, (4) cardiac ICU, (5) burn unit, and (6) pediatric ICU. We propose to evaluate value and outcomes in the following domains: (1) patient safety-medication errors (evaluation of ADEs), (2) quality of care (length of stay, mortality, complications and use of prophylaxis), (3) end users' job tasks and perceptions and attitudes (questionnaire survey and observations of job tasks), and (4) financial impact (data derived from the hospital accounting system). The information learned will advance the scientific knowledge in patient safety in two ways: (1) there will be a better understanding of medication errors and the impact of CPOE technology on number and severity of these errors in ICUs, and (2) the human factors approach to technology implementation in health care and the effects on the end users will be shared concerning a new technology that is likely to be widely adopted in the next few years, namely CPOE technology.